The language of Never Again should resonate – we should not have to mobilise to Save the NHS – that was only necessary because it has been underfunded and successive governments had failed to prepare for the pandemic – although a pandemic was at the top of the UK's risk register
Today is the 72nd anniversary of the founding of the NHS in 1948 as part of the post-war consensus. For 10 weeks on Thursday evenings large numbers of people have stood at their front doors or on balconies to applaud the NHS expressing their appreciation for the people who deliver the medical care. During the lockdown many people "noticed", many for the first time, the efforts of those whose work enables our society to function. The clapping has been for the NHS staff who worked tirelessly to deliver the health service we and they care for. Today is a day for celebration and remembrance. Clapping is not enough NHS wages for many staff are low and the service, in which the country takes such pride, is underfunded. Dangerously underfunded in its unpreparedness to tackle the Covid-19 pandemic. As we shall see it knew that it was unprepared. There is no realistic prospect of pay rises for NHS staff from porters and security staff to consultants.
As Maurice Glasman has pointed out one of the consequence of the pandemic has been "the visibility and necessity of the working class." Those who stack shelves, collect the rubbish, maintain the sewers, deliver the post - these workers so often 'invisible' have been at work throughout the pandemic. They are the working class, the workers who cannot work from home. "Covid-19 has reminded us of the "importance of the working class to our well-being and survival is recognised as it has not been for decades, and labour value has been reaffirmed" writes Glasman.
"People working in elementary jobs faced the greatest risk. Of those, there were more security guard deaths than in any other profession at 74.0 per 100,000, or 104 deaths." Telegraph
How soon will we forget? It seems likely that we shall forget very quickly. As Edmund Burke, a founding father of Conservatism. pointed out "Those who don't know history are doomed to repeat it.” If we fail to learn from past mistakes we shall repeat them.
The government pledged to give the NHS whatever it needs to tackle the pandemic. The Chancellor will on Wednesday spell out his plans for public spending. NHS England says that it needs and additional £10bn. The annual NHS budget is £140bn, if provided that would be an increase of 7%. £10bn is the NHS's estimate of the cost of fighting the virus and reopening the normal services. The money would mean the NHS could create extra beds in hospitals, keep the Nightingale facilities on standby, send patients to private hospitals for surgery and provide protective equipment for frontline staff. The sticking point in the negotiations between the NHS/Department of Health and Social Care and the Treasury is reported to be the NHS’s insistence that the Treasury continues to underwrite the £400m-a-month cost of the contract the Department agreed with private hospitals in March to treat NHS patients. The Treasury is insisting that the temporary contract with the private hospitals be maintained for fear of waiting list hitting 10m by Christmas. more
At some point in the future there will doubtless be an inquiry into the government's handling of the pandemic and the preparations for epidemics made by successive governments. However, preparations need to be made now. There is a significant risk that Covid-19 will return and and that the NHS will again risk being overwhelmed. Much of what follows is based on the Daily Telegraph (DT), widely referred to in the UK as the "Torygraph," the daily paper of the Conservative Party.
There have been many mistakes:
Successive governments, including the current one, have said that they will solve the social care problem. Without a solution the NHS will continue to suffer from bed blocking.
The Daily Express on June 3rd published the results of a poll it funded: "A damning survey for the Daily Express reveals two-thirds of those aged 55-plus support the increase. And 41 percent across all age groups agree that a ring-fenced general tax increase is the best way forward. They want an end to the scandal of pensioners handing over their savings and selling their homes to pay for care. The system's failings have been cruelly exposed by the coronavirus pandemic......Our poll found more than half of the 2,094 adults aged 55-plus (58 percent) believe it is unacceptable to force the older generation to sell their family homes to pay care home bills. And 49 percent across all ages agreed. Almost the same number (54 percent) believe it is unfair to put property or a hard-saved nest egg into a means test to qualify for financial help.
The Covid-19 crisis has raised serious concerns about governance and the preparatory planning for pandemics and decision making during this one. Awareness of the crisis in health and social care is now very clear. Although some have presented this as a source of intergenerational conflict, the elderly who have died are the parents and grandparents of people now concerned about their own care in old age.
There is an urgent need to develop a consensus to tackle some of the fundamental challenges that the UK faces and which require a consistent approach over several parliaments if the UK is to thrive. The collective expression of support for NHS and Social Care staff expressed in clapping on Thursdays at 8 pm for 10 weeks is indicative of public support and love of the service. There is strong public support for the NHS combined with mounting concern for its future.
Failures by successive governments to ensure adequate preparations for a pandemic resulted in the government priority to defend the NHS, just when we should have been able to rely on the NHS to defend us. In the front line, the doctors, nurses, porters and cleaners did defend us, despite the lack of preparation and of the PPE to do it. This was achieved by discharging elderly patients, untested for Covid-19, into Social Care. One-third of all UK fatalities form Covid-19 were in care homes, 16,000.
Much of the NHS is managed by the developed assemblies in Scotland, Wales and Northern Ireland leaving the UK government to oversee England.
Britain needs to ensure that the NHS is adequately funded and is resilient to cope with pandemics. The scientists expect that there will be further epidemics and pandemics. The next one may be more or less aggressive and deadly. It would be prudent to assume that the next one will be worse and plan for it. Successive governments has failed to reform social care, was unable to ensure the maintenance of adequate stock piles of PPE and ventilators, and failed to provide robust Public Health services, including having a track and trace system in place to scale up in the face of a pandemic. There should have been an app in place prior to the pandemic to facilitate track, trace and isolate.
Covid-19 has revealed significant weakness in the UK’s ability to deal with a pandemic. This has raised some fundamental questions about the competence of government, civil service, Public Health England, local government and the NHS. Funding for resilience is always easy to cut, the important displaced by the urgent. A system-level review is required to ensure that the UK is prepared for the next epidemic or pandemic.
Between 2011 and 2018, the WHO tracked 1483 epidemic events in 172 countries. The World Bank (09/2019) published A World at Risk, the graphic below comes from page12. It would be foolish to think that Covid-19 is the last event of its kind. The World Bank concludes that we are entering a “new era of high-impact, potentially fast-spreading outbreaks that are more frequently detected and increasingly difficult to manage.”
As of late May there had been a very significant fall in people's confidence in the government's handling of the pandemic. Guardian
Justin Francis CEO of Responsible Travel
I have a very strong feeling that we are absolutely NOT all in this together when it comes to the tourism COVID recovery. I don’t recognise, or like how our industry is being characterised (cruise ships, airlines, tech giants needing tax payer bailouts). For me this is not the bedrock of tourism, or those most in need. Read his view here.
James Frayne, Director of Public First and author of Meet the People, a guide to moving public opinion, writes on Conservative Home that the country will have to undertake a comprehensive Fairness Audit of the Coronavirus crisis, and sets out five critical issues that must be addressed.
At some point in the not-too-distant future, informally or formally, the country will undertake a comprehensive Fairness Audit of the Coronavirus crisis. Read his view here
Simon Sappers, of Labour Campaign for Human Rights (LCHR), describes how theCovid crisis has brought Social Rights into sharp relief
The ongoing Covid crisis has brought the issue of so-called Social Rights into sharp relief. These rights are to food, housing, health, work and education, and whilst novel in the UK, are not uncommon in other countries.
Read his view here.
Matthew Taylor Royal Society of Arts
The path from crisis
The Covid-19 pandemic is generating momentum for change in many parts of society. But perhaps the biggest shift of all would be an appetite for new leadership. Read his view here
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